The effect of humeral tray thickness on glenohumeral loads in a reverse shoulder 'smart' implant.

Autor: Caubère A; Department of Orthopaedic surgery and Traumatology, Military Hospital Sainte-Anne, 2, Bd Sainte Anne BP600, Toulon, 83800, France. alexandre.caubere@hotmail.fr.; Sainte-Anne Military Hospital, 2, Bd Sainte-Anne, BP 20545, 83041, Toulon, Cedex 9, France. alexandre.caubere@hotmail.fr., Rutigliano S; Statera Medical Inc, Montreal, QC, Canada., Bourdon S; Statera Medical Inc, Montreal, QC, Canada., Erickson J; Overlook Medical Center, Summit, NJ, USA., Morelli M; Department of Orthopaedic Surgery, St Mary's hospital, McGill Medical University, Montreal, QC, Canada., Parsons M; The Knee, Hip and Shoulder Center, New Hampshire, USA., Neyton L; Ramsay Générale de Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France., Gauci MO; Universitary Insitute of Locomotion and Sport, Pasteur II Hospital, Nice, France.
Jazyk: angličtina
Zdroj: International orthopaedics [Int Orthop] 2024 Nov; Vol. 48 (11), pp. 2881-2889. Date of Electronic Publication: 2024 Sep 02.
DOI: 10.1007/s00264-024-06282-6
Abstrakt: Purpose: The aim of this study was to observe the effects of changing humeral tray thickness on the resultant of intraoperative glenohumeral joint loads using a load-sensing system (LSS).
Methods: An rTSA was performed on fresh frozen full-body cadaver shoulders by using an internal proprietary LSS on the humeral side. The glenohumeral loads (Newtons) and the direction of the resultant force applied on the implant were recorded during four standard positions (External rotation, Extension, Abduction, Flexion) and three "complex" positions of Activity Daily Life ("behind back", "overhead reach" and "across chest"). For each position, the thickness was increased from 0 to 6 mm in a continuous fashion using the adjustment feature of the humeral system. Each manoeuvre was repeated three times.
Results: All shoulder positions showed a high repeatability of the glenohumeral load magnitude measured with an intra-class correlation coefficient of over 0.9. For each position, we observed a strong but no linear correlation between humeral tray thickness and joint loads. It was a cubical correlation (r s = 0,91) with a short ascending phase, then a plateau phase, and finally a phase with an exponential growth of the loads on the humeral implant. In addition, an increase in trail-poly thickness led to a recentering of force application at the interface of the two glenohumeral implants.
Conclusion: This study provides further insight into the effects of humeral implant thickness on rTSA glenohumeral joint loads during different positions of the arm. Data obtained using this type of device could guide surgeons in finding the proper implant balance during rTSA.
(© 2024. The Author(s) under exclusive licence to SICOT aisbl.)
Databáze: MEDLINE
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